Beyond glycemic control: differential effects of empagliflozin and sitagliptin on insulin sensitivity and a shared increase in adropin in type 2 diabetes
Abstract
Background: Type 2 diabetes mellitus (T2DM) is characterized by metabolic and inflammatory disturbances beyond hyperglycemia. Hepatokines such as adropin have emerged as regulators of insulin resistance and vascular function, yet the comparative metabolic effects of sodium-glucose cotransporter 2 (SGLT2) and dipeptidyl peptidase 4 (DPP-4) inhibitors on adropin remain unclear. This study compared the effects of empagliflozin versus sitagliptin, each added to metformin, on serum adropin, insulin resistance, glycemic control, lipid profile, and inflammation in adults with T2DM.
Method: In this single-center, randomized, open-label, parallel-group superiority trial with blinded outcome assessment and blinded statistical analysis, 100 adults with inadequately controlled type 2 diabetes mellitus (HbA1c ≥ 7.5%) receiving stable metformin therapy were allocated in a 1:1 ratio to receive empagliflozin 10 mg once daily or sitagliptin 100 mg once daily for a 12-week intervention period. The co-primary outcomes were changes in circulating adropin concentrations and insulin resistance, assessed by the homeostasis model assessment of insulin resistance (HOMA-IR). Secondary outcomes included changes in HbA1c, fasting insulin, lipid parameters, body weight, and tumor necrosis factor-α (TNF-α). All analyses were conducted according to the intention-to-treat principle.
Result: Ninety‑four participants completed the intervention; all were included in analyses. Serum adropin increased from 291…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 100 participants or records.
Read the paper
Related studies
- Metformin as an adjuvant in breast cancer treatment
- Metformin Lysosomal Targeting: A Novel Aspect to Be Investigated for Metformin Repurposing in Neurodegenerative Diseases?
- Aberrant HSF1 signaling activation underlies metformin amelioration of myocardial infarction in mice
- Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines
- Protein Interaction Network for Identifying Vascular Response of Metformin (Oral Antidiabetic)
- Preventing Long COVID With Metformin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.